Remote RN Care Coordinator - Utilization & Medical Policy
Premera
Premera is seeking a Care Coordinator - Retrospective to evaluate clinical requests across various lines of business. The successful candidate will partner with Medical Directors to ensure compliance and effective care. Responsibilities include performing medical necessity reviews and maintaining a thorough understanding of provider contracts and clinical criteria. Qualified candidates will have a Bachelor’s degree or equivalent work experience along with current RN licensure. #J-18808-Ljbffr
$90k - $105k
...RN Clinical Care Coordinator Position: RN Clinical Care Coordinator Pay Range: $90,000 - $105,00... ...Clinical Care Coordinator Work Type: Remote/In the Field Position Summary... ...or chest X-ray as required by Agency policies and procedures. Must be free from signs...Remote workPolicyWork at officeLocal area$28.94 - $51.83 per hour
...simplifying the health care experience, creating... ...together. The RN Field Clinical Care Coordinator, you will be an... ...including assessment of medical, behavioral,... ...Care ~ Ability to utilize an Electronic Medical... ...Group's Telecommuter Policy. **PLEASE NOTE** The...Remote workPolicyHourly payDaily paidMinimum wageFull timeTemporary workPart timeWork experience placementLocal areaRelocation packageFlexible hours$40 - $45 per hour
...Immediate need for a talented RN Care Management Coordinator . This is a 03 months... ...-term potential and is Remote , but the candidate... ...based on advanced medical knowledge to cases, utilizing specified resources and... ...ASAM), Care Management Policy, Medical Policy, and Electronic...Remote workPolicyContract workLocal areaImmediate start- ...RN Transitional Care Coordinator-Lake West A Brief Overview: Ensures appropriate... ...approach. Provides updates to medical team and nursing of... ...assigned. Complies with all policies and standards. For specific... ...and knowledge of utilization management, case management...Remote workPolicyWork experience placement
$28.94 - $51.63 per hour
...simplifying the health care experience,... ...to start The RN Clinical Care Coordinator will be the... ...members with complex medical/behavioral needs... ...appropriate utilization of services and... ...flexibility to work remotely* as you take on... ...'s Telecommuter Policy Pay is based...Remote workPolicyHourly payMinimum wageFull timeWork experience placementLocal area$28.94 - $51.83 per hour
...Social Services Coordinator At... ...simplifying the health care experience, creating... ...to work remotely* as you take on... ...~ Current RN unrestricted license... ...Populations, Complex medical conditions ~... ...Experience in utilization review,... ...s Telecommuter Policy. Pay is...Remote workPolicyHourly payMinimum wageFull timeWork experience placementLocal areaMonday to Friday$74 per hour
...RN Care Coordinator- Full-Time Professionally develop and enhance... ...). Location: Some remote work and some in-person... ..., and coordinate utilization of community resources... ...knowledge of new laws/policies that affect member care... ...PandoLogic.Keywords:Medical Case Manager,...Remote workPolicyDaily paidFull timeTemporary workPart timeInterim roleWork at officeLocal areaShift work- ...demands of hands-on care behind. Instead,... ...dedicated team, coordinate whole-person medical care, and finally... ...Care: Provide remote and in-person consultative... ...Coordination: Utilize our Electronic... ...robust internal policies. Crisis... ...Registered Nurse (RN) license in the State...Remote workPolicyFull timePart timeWork at officeLocal areaImmediate startMonday to FridayFlexible hoursShift workNight shiftWeekend workAfternoon shift
- ...Chronic Care Management RN Coordinator Southwest Health 1 Positions... ...to obtain their medical history and chief complaint... ...Compliance Policy, Code of Conduct and... ...MercyOne Fabrication Utility Mi-T-M Corporation... ...AVP Client Services | Remote In Midwest Preferred...Remote workPolicyFull timeTemporary workFlexible hoursShift workWeekend workDay shift
$28.94 - $51.63 per hour
...Care Coordinator At UnitedHealthcare, we're simplifying... ...member's medical, behavioral, and... ...promote appropriate utilization of services and... ...flexibility to work remotely as you take on... ...of the below: RN LCSW, LMSW, LSW... ...Group's Telecommuter Policy. Pay is based...Remote jobPolicyHourly payMinimum wageFull timeWork experience placementLocal area- ...Health & Services is hiring a Utilization Review RN for a remote position focused on administering medical management programs,... ...Washington. This role encompasses care coordination and discharge planning, along... ...with various compliance and policy development duties. A...Remote workPolicy
$28.94 - $51.83 per hour
...Integrated Care Coordinator At UnitedHealthcare, we're simplifying the... ...adult members with a variety of medical and/or behavioral health... ...needs to promote appropriate utilization of services and improved... ...UnitedHealth Group's Telecommuter Policy. Pay is based on several...Remote workPolicyHourly payMinimum wageFull timeWork experience placementLocal areaMonday to Friday- ...The Unit Clinical Care Coordinator (Unit C3) is responsible... ...plan, there is efficient utilization management, treatment... ...'s primary care team (RN, physician). Oversees... ...Consults and educates medical and nursing staff on... ...equipment. "It is the policy of Mary Washington...PolicyImmediate startShift workNight shiftAfternoon shift
- ...designated as a regional Coordinated Care Organization (CCO) for... ...Together. This is a remote position in which we... ...: ~ ~ Health plan utilization management ~ Medicare... ...benefit structure and policy. ~ Data analysis to... ...Current unencumbered Oregon RN License required...Remote workPolicy
- ...Utilization Case Manager RN The purpose of the Utilization Case Manager RN is... ...initial chart reviews for medical necessity and identify the... ...Utilization Case Manager RN coordinates with the healthcare team... ...coverage benefits and payer policy limitations to determine...Remote workPolicy
- ...Health Plansis hiring an Utilization Review Nurse/RN- Remote in Virginia Status: Full... ..., retrospective review, medical director referrals and... ..., continued stay review, care coordination, or discharge planning for... ...applicable criteria, medical policy, and member eligibility,...Remote workPolicyPermanent employmentFull timeTemporary workShift work
- ...Cottage Hospital is seeking a qualified RN or LPN to perform remote utilization reviews. The ideal candidate will ensure compliance with policies and collaborate effectively with client... ...clearly. Excellent benefits including medical, dental, and vision insurance are offered...Remote workPolicyWork at office
$23.76 - $51.49 per hour
...verifying that services are medically necessary and align... ...guidelines, insurance policies, and regulations - ensuring... ...integrated delivery of care across the continuum.... .... • Adheres to utilization management (UM) policies... ...• Registered Nurse (RN). License must be active...Remote workPolicyHourly payWork experience placementWork at office- ...effective resource coordination to help patients achieve... ...health, access to care and appropriate utilization of resources,... ...level of care based on medical necessity. This position... ...standards and Tenet policy Education provided... ...Saturday schedule. Remote, but you must live locally...Remote workPolicyWork at office
$28.94 - $51.63 per hour
...Clinical Coordinator At UnitedHealthcare, we... ...simplifying the health care experience,... ...applying approved medical necessity criteria... ...flexibility to work remotely from anywhere within... ...transportation, utility assistance, housing... ...Group's Telecommuter Policy Pay is based on...Remote workPolicyHourly payMinimum wageFull timeWork experience placementLocal areaMonday to Friday$23.76 - $51.49 per hour
...verifying that services are medically necessary and align... ...guidelines, insurance policies, and regulations - ensuring... ...integrated delivery of care across the continuum.... ...care model. Adheres to utilization management (UM)... ...experience. Registered Nurse (RN). License must be...Remote workPolicyHourly payWork experience placementWork at office$31 per hour
...Job Title: RN Managed Care Coordinator Location: Columbia, SC (1 week of onsite training and then remote) Duration: 3-month assignment with possible... ...: Evaluate medical eligibility for benefits and... ...expertise and administrative policies. Provide health management...Remote workPolicyLocal area- ...Embedded Clinical Care Coordinator - Utilization//Pediatrics/InterQual Embedded Clinical Care Coordinator... ...as other approved guidelines and medical policies. Promotes quality and efficiency in... ...Qualifications: Current DE/Compact RN license and/or additional states as...Policy
$39 - $40 per hour
...Management Registered Nurse (RN)Type: 6-Month Contract W2Location: Remote - but MUST reside in... ...: We are seeking a Utilization Management RN to join our... ...healthcare services, coordinating care, and ensuring members receive... ...with Judge's Privacy Policy, information obtained...Remote workPolicyDaily paidContract workMonday to FridayShift workWeekend work- ...Health Living Classes (Shared Medical Appointments), individual... ...appropriate VA classes, and utilization of Population Health principles... ...making decisions about health care services, settings, and organizational... ..., and implementation of policies and procedures in current and...Remote workPolicyPermanent employmentRelocation packageMonday to Friday
- ...Job Summary: The Virtual Care Coordinator supports remote patient monitoring and... ...Monitor real-time data, analyze utilization reports, and assess... ...experience developing telehealth policies, protocols, and workflows.... ...proficiency in electronic medical records and remote...Remote workPolicy
- ...opportunities as a Progressive Care Clinical Nurse Coordinator RN you want in your current... ...with established policies/procedures, serves as a resource... .... ~Triages the patient utilizing age, developmentally appropriate... ...benefits for medical, prescription drug, dental...PolicyHourly payTemporary workImmediate startWork from homeFlexible hoursShift work
- ...LPN Care Coordinator (1099 Contract | Fully Remote) Make a meaningful impact—one call at a time! Are you a detail-... ...patient care. ✔ Tech-Enabled Work – Utilize EMR systems and digital tools to... ...with Medicare, HIPAA, and company policies. Engage in high-volume patient outreach...Remote workPolicyContract workFlexible hours
$45.9 - $71.4 per hour
...Description Utilization Review RN - Remote. The RN Care Coord‑Qual Med Mgmt will provide administration of medical management programs that include prior... ..., delegation, medical policy development and medical... ...claims and other data, care coordination and discharge planning....Remote workPolicyHourly payLocal area- ...Every One. Job Title RN Care Coordinator - Orthopedics Location... ...pm. There may be occasional remote days. A caregiver who excels... ...disease-specific, age-specific, medical, behavioral, pharmacy,... ...for procedures. The policy of Cleveland Clinic Health System...Remote workPolicyShift work
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